A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?
A visitor experiences a minor burn after spilling coffee
A parent wants her 14-year-old adolescent to receive radiation treatment against his will
A nurse witnesses another nurse administer an incorrect medication
A client receives an operation on the wrong side of her body
The Correct Answer is B
a. A visitor experiencing a minor burn is a safety incident but not necessarily an ethical dilemma.
b. This scenario involves a conflict between parental autonomy and the adolescent's right to refuse treatment, representing an ethical dilemma.
c. This scenario involves a medication error, which is a patient safety issue but not necessarily an ethical dilemma unless there are complex issues surrounding the circumstances of the error.
d. Operating on the wrong side of a client's body is a serious medical error and a patient safety issue but may not inherently involve an ethical dilemma unless there are factors such as informed consent or negligence involved.
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Correct Answer is D
Explanation
a. While the client's refusal of care from assistive personnel of the opposite gender is important, it may not be as urgent as addressing staffing shortages.
b. While the unavailability of transport assistance is concerning, it does not pose an immediate risk to patient care compared to understaffing.
c. The disagreement between two nurses about a scheduling issue is important but may not have an immediate impact on patient care.
d. Staffing shortages due to three staff members being absent have the potential to significantly impact patient care and require immediate attention from the nurse manager.
Correct Answer is C
Explanation
A. Offering a sedative is inappropriate and does not address the client’s right to refuse care. The nurse should focus on ensuring the client understands the risks of leaving.
B. Informing the client that she cannot leave without a discharge prescription is incorrect because an adult client has the legal right to leave against medical advice (AMA).
C. Having the client sign the Against Medical Advice (AMA) form is the appropriate action, as it documents that the client understands the risks of leaving and is doing so voluntarily.
D. Assigning a security officer to the client’s room is unnecessary unless there is a safety concern, which is not indicated in this scenario.
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